In Nutrition and Obesity Everyone Has an Agenda

We are living in an age of low trust. Trust in scientists declined through the pandemic and around the world, trust in elected officials registers at very low levels. Because of this, we are absolutely not surprised with the frequent finger-pointing and stories about conflicts of interest in nutrition and obesity. These are subjects that stir up strong feelings and biases. So let’s be clear. Everyone has an agenda in nutrition and obesity.

Righteous Indignation

The latest example of finger-pointing comes in an open letter in the BMJ, calling for removal of corporate sponsorship from the European Congress of Obesity. “It is time to remove corporate sponsorship and presence in scientific and healthcare events,” they write. The authors express dismay that employees of corporations “may participate as attendees and speak at sessions.”

We need to call out these people, they say:

“Badges of participants who attend the event on behalf of a company in the food, pharmaceutical or other industry should carry that information.”

But we must define what qualifies as an industry. Most people who attend professional conferences are employed. Employers have a business that requires money. Some are for profit. Some are nonprofits. Even so, anyone who has worked for a large nonprofit business know that money is quite important and institutional dogma can be quite strong in such organizations.

White Hat Bias

In our experience, there is no greater source of bias than belief in the righteousness of one’s cause. Mark Cope and David Allison described this as white hat bias. Mike Albert has something similar in mind when he talks about nutrivangelism.

For example, the Physicians Committee for Responsible Medicine is a nonprofit that zealously promotes vegan diets. The name might lead you to think this is a medical organization. But its work is all about animal rights and vegan diets. This is not surprising, given its close affiliation with PETA. There’s nothing wrong with pursuing this agenda, but it is quite an all-consuming agenda. PCRM’s pursuit of it is every bit as dogged as any corporation in pursuit of business interests.

Nonprofit health systems can also be quite tenacious in pursuing billions of dollars in revenue, begging questions about whether they are indeed charitable organizations.

Even academics can find themselves very invested in certain ways of thinking about a problem such as obesity. For a hint of this, consider how “riled up” people seem to get about the carbohydrate-insulin model for explaining obesity.

Transparency and Humility

Without a doubt, there are some clear examples of bad actors in this space. We have no shortage of hype and misinformation spewing forth – both from people seeking to make a profit and others trying to advance their cause.

But a bit of humility and transparency about our own biases would do us all good. People who live in glass houses and throw stones will run into problems.

Click here for the demanding letter in the BMJ, here for a brief response from EASO, and here for further perspective on the righteous health agendas.

Justine Greening Concludes the Nutrition for Growth Conference, photograph by Marisol Grandon and the UK Department for International Development, licensed under CC BY 2.0

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April 2, 2023